Interview with Jordan Fersel, MD, author of When Bad Backs Happen to Good People

Title: When Bad Backs Happen to Good People

Author: Jordan S. Fersel, MD

Publisher: iUniverse

Genre: Medical

Format: Ebook

Chronic back and neck pain is a thorny issue that plagues millions living in today’s modern world and has the power to take over a person’s life—not just physically, but also psychologically, emotionally, and physiologically. The good news is that there are effective ways of dealing with chronic pain that allows patients to return to a productive life without undergoing unnecessary surgery. Dr. Jordan Fersel is a board-certified pain specialist who relies on his diverse professional experience to distinguish the differences between acute and chronic pain, scrutinize the accuracy of an MRI scan to diagnose pain, examine the architecture of the spine, explain nerve injuries, differentiate between the various types of arthritis, and offer potential treatment options. Through included case studies and illustrations, pain sufferers will learn there is hope for managing pain through proper diagnosis and a treatment plan tailored to treat individual needs. It’s Not All in Your Head shares guidance from a trusted physician that explores chronic back and neck pain, its sources, and the many treatment options available.

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Question1- How did you come up with the title of your book? The title of my book derives from my many years of dealing with chronic pain sufferers and expresses my feelings toward many of them. This group of patients represents some of the most unfortunate people you can ever meet. Their lives are going along quite swimmingly for many years and then, for many of them, there is some trauma or illness which leaves them  with long-term debilitating pain. These patients did not choose this path, and in some sense they are victims of their experience. King Solomon wrote in Ecclesiastes that in some ways humans are no different from animals in the sense that just as animals can be suddenly trapped or fish caught in a net, so too human beings are vulnerable to sudden changes in their lives which can totally alter their existence. Chronic pain is such an experience. I also wanted a catchy title that people would remember and relate to. I want people to think about the classic best seller by Rabbi Harold Kushner, When Bad Things Happen to Good People, because chronic pain is one of those things. I also wanted patients to know that there are real, physical reasons for their painful experience and for that reason the supra title is, It's Not All in Your Head. I deal with all this in my book, but the most important takeaway is that chronic pain patients are particularly unfortunate because medical science has provided no good way to diagnose or measure their experience of pain and suffering, and in many cases we have only been able to offer generic treatments such as anti-inflammatory drugs, and narcotics in severe cases. I won't go into the politics of it all here, but imagine the exasperation of someone who is in pain despite no fault of their own, can not receive appropriate treatment because of the ambiguities of their complaints and the lack of objective medical tests, and now the denial of medications that do not cure, but may ameliorate their symptoms. Traditional Western medicine has failed many of these people, and yet viewed in the proper context, their symptoms do fit into the traditional medical model - it just takes a bit of imagination and creativity to understand why. These folks need not only encouragement, but also a systematic approach to escaping from their unfortunate situation. I think I have provided some tangible solutions in my book for many people in chronic pain.

Question2- What is your writing environment like? My writing environment is a simple cluttered desk with a picture window in front of me. I guess I like to daydream or collect my thoughts at times before writing them down, and as I write now, I am watching the snow fall. Paradoxically, distraction helps me concentrate. Usually the radio is playing some music from my college years in the background. It is quiet, but it is also kinetic. It works for me but I wouldn't recommend it for everyone.

Question3- What are some of the best tools available today for writers? I consider myself someone who asks questions and then seeks to find the path that takes me toward the answer. I think in my case, it has been a journey of decades and of a professional career. Resources have evolved with time from medical libraries to CD ROMs, from lectures and conferences to internet research. As of today, I think Google, Wikipedia, and Creative Commons have been great resources to start a project with. It was relatively easy to locate research articles. My greatest difficulty was to find illustrations in the public domain. I think that is a problem for anyone who wants to include pictures or illustrations.There are solutions but they are not cheap.

Question4 – What inspires you to write? There are many things that have inspired me to write this book. First, the concepts have been looming in my head for a long time and kind of stalking me like the ghost in Macbeth. But many of these ideas have only recently crystallized in my head. At the beginning of my book I quote the chemist, August Kekule, the discoverer of the benzene ring, who describes a similar experience. My ideas at this point are theoretical in nature, but they fit the facts very nicely. That is similar to the experience of Kekule. The better the theory fits the actual experience, the better we will be able to answer the difficult questions, and even if the theory is not perfect it advances us down the path toward the real truth. Theorists are truly builders of castles in the sky, but some of those castles come to have their foundations on terra firma. In practical terms, neck and back surgery do not have the best results in the experience of many patients, I think I understand the reason for this and I try to discourage patients from having surgery out of frustration with their pain. There are cases in which surgery is absolutely necessary and I do devote a chapter to that as well. But the worst sufferers are those who have had unnecessary surgery - I want to focus patients on getting a proper diagnosis and treatment. There is too much guesswork involved in uncovering primary causes for pain because of the absence of meaningful diagnostic testing. I do not have all the answers, and I think it's all right to not have all the answers at this time, but I think that in terms of chronic pain we should always progress from the least invasive therapies to the more invasive therapies incrementally and with mindfulness, otherwise we risk destroying people's lives. There are no easy answers, but there can be systematic approaches. That is what I have come to advocate.

Question5 – Did you learn anything while writing this book? I have learned so much writing this book. The first is that I miss writing. We used to start every English class in 10th grade with writing for ten minutes, I owe my teachers a debt of gratitude for making me write. I also found that I needed to take some very dry ideas and make an effort to make them seem more relatable and accessible to the average person. I think that was a great challenge and I will find out how well that works out. I had to clarify and strengthen some of the ideas that I have in my head, and I was actually able to find new therapies for the treatment of chronic pain based on my theories, which are related to the bodies own capacity to heal itself. I think the field of Regenerative medicine will become very important in the near future and I think that it holds great promise and also some of the secrets for treating chronic pain, but that is the topic for another book. I have learned that I can complete a project despite multiple obstacles and frustrations. I have learned not to be silent, even in the face of controversy.

Question6- What is your favorite quality about yourself? I think my best quality is my resilience. I have been tested in many ways, but I am stubborn and I keep coming back. I don't know any other way. It is exhausting at times, but as you travel through life you find that there are important messages that need to be taken through the birthing process, and as everyone knows delivering a baby is a painful process... unless you have a nice epidural.

Jordan Fersel, MD, is a board-certified, pain-management fellowship-trained physician who earned a BA in biology from Queens College and an MD degree from Mount Sinai School of Medicine. He has been director of Pain Management Services at Trinitas Medical Center Oncology Unit for several years. Dr. Fersel and his wife, Esty, divide their time between Philadelphia and West Orange, New Jersey.